Metal content in soil and black spruce (Picea mariana) trees in the Sudbury region (Ontario, Canada): low concentration of arsenic, cadmium, and nickel detected near smelter sources.

Several studies have reported high metal concentrations in soil within the vicinity of smelters in the Sudbury (Ontario) region. Continued investigation and monitoring of soil and vegetation are essential to the understanding of ecosystem recovery following the reduction of emissions from smelters and the establishment of a reforestation program. The concentrations of Cd, Co, Cu, Fe, Ni, and Zn, found in the present study were within the limits set by Ontario Ministry of Environment and Energy (OMEE) guidelines even in sites within the vicinity of the Falconbridge Smelters. The levels of these elements in black spruce (Picea mariana) tissues were much lower and far below the toxic levels for vegetation. This is the first documented report of metal content in black spruce populations in the Sudbury region.

Hematuria home screening: repeat testing results.

To determine at what interval screening should be repeated to detect bladder cancer before it becomes muscle invasive 856 men who had 14 negative daily home tests for hematuria with a chemical reagent strip 9 months previously performed repeat tests. Of these men 50 (5.8%) had at least 1 positive test during the second 14-day screening period and 38 were evaluated, 15 of whom (39.5%) had significant urological pathological conditions, including 8 with malignancies. Bladder cancer was noted in 7 men, with no tumor invading the muscularis propria. The finding of 7 bladder cancers in 856 men (0.82%) who had a negative test 9 months previously indicates that bladder cancer has a brief preclinical duration and that testing must be repeated at least annually for screening to detect bladder cancer consistently before invasion occurs.

Home screening for hematuria: results of a multiclinic study.

The majority of urinary tract tumors cause bleeding in the urine. A program designed to detect hematuria before it is grossly apparent may contribute to earlier detection and more successful treatment of these malignancies. To test this hypothesis a hematuria home screening study was conducted. A total of 1,340 healthy men 50 years old or older used chemical reagent strips for 14 consecutive days to test the urine. Of the men 283 (21.1%) had at least 1 episode of hematuria. Of the 192 hematuria positive men who received a complete urological evaluation 16 (8.3%) had urological cancers and 47 (24.5%) had other hematuria-causing diseases that required immediate treatment. The quantity and frequency of hematuria were not related to disease severity. A hematuria home screening regimen is feasible and economical, and may promote the early detection of urinary tract cancers and other diseases in men more than 50 years old.

Age as a predictor of an aggressive clinical course for superficial bladder cancer in men.

Tumor grade and stage are two of the strongest predictors for indolent versus aggressive clinical course in bladder cancer. To identify age-related trends in tumor aggressiveness the authors investigated the relationships of age with grade and stage. Pathologic specimens were obtained for 89% (527 of 590) of new bladder cancer cases among men older than 50 years of age reported to the state tumor registry in Wisconsin for 1988. Tumors were grouped as low grade (G1, G2) or high grade (G3), and as superficial (Ta) or invasive (greater than or equal to T1), according to the TNM system. This analysis included 485 transitional cell carcinomas (TCC) for which the authors determined stage-stratified and grade-stratified odds ratios for men 50 through 64 years of age and older than 65 years of age. Men older than 65 years of age with superficial TCC were more than three times as likely to have a high-grade malignancy than men 50 through 64 years of age (P = 0.01); the odds ratio was 3.44 (95% CI = 1.28, 9.26). A relationship was not apparent for invasive TCC. Age and stage were weakly associated for low-grade and high-grade TCC that may be due, in part, to the strong correlation of stage with grade as a prognostic indicator. These data suggest that men in older age groups are at increased risk for superficial bladder cancer of high grade, which portends an aggressive clinical course.

Hematuria screening for bladder cancer.

Detection of bladder cancer before deep invasion occurs offers patients a favorable prognosis. Because most bladder cancers, even when noninvasive, produce hematuria, screening asymptomatic persons at risk for bladder cancer for hematuria provides a means of promoting early detection and has the potential to reduce morbidity and mortality. However, bladder cancer-induced hematuria is quite intermittent; thus, repetitive testing is necessary. In a pilot study, 11.4% of asymptomatic men over age 50 who had at least one positive dipstick result were found on urologic work-up to have bladder cancers that were caught early enough to receive purportedly curative treatment. Issues concerning the applicability of this methodology to other high-risk populations are discussed and efforts now underway to confirm and expand upon this screening program are described.